The Role of Pulmonary Angiography in Pulmonary Embolism

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Abstract
The major angiographic findings in making a diagnosis of pulmonary embolism were anatomic and pathophysiologic alterations. The anatomic changes in the pulmonary arteries were: obstruction, intraluminal filling defects, vessel wall defects, and vessel caliber changes. The pathophysiologic manifestations in the pulmonary circulation were: stagnation or retarded flow, diminished flow, and avascular areas. Additional findings were seen in the heart by the technique described; intracardiac thrombi, dilatation of the right heart, tricuspid insufficiency, and dilatation of the azygos vein and superior vena cava. Furthermore, pulmonary angiography provides a method for the evaluation of the fate of pulmonary emboli and the possible role played by associated left-heart disease. It was thought that radioisotope scanning furnishes no definite information concerning the patency of pulmonary arteries. Selective anteriography provides a specific means of determining the location and the extent of pulmonary lesions. More experience and the refinements of new diagnostic techniques may hopefully offer clues to the diagnosis of those cases which are often misdiagnosed.

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